"As this law passed two years ago, my main concerns were that this massive overhaul did not reduce individuals' health care costs and that it added hundreds of billions to the federal deficit," Wittman said. "Today's ruling did not change those outcomes, and in fact, underscored the law's added burdens: more taxes for middle class individuals and families and small businesses working to survive in this tough economy. The requirement that all individuals must purchase health insurance or be subject to a tax may have been found constitutional with a 5-4 decision, but it is still unaffordable and unworkable for individuals and this country. I have and will continue to support a repeal of this law and action to replace it with commonsense solutions that lower costs while increasing access to care. I will continue to support limiting the federal government's reach, to protect the patient-provider relationship, and to advocate for solutions promoting affordability and accessibility of health care.

***

Adam Cook, the Democratic candidate challenging U.S. Rep. Rob Wittman in the 1st Congressional District, said it's time for Republicans and Democrats to move forward together "to fix the parts of the law that are broken."

"With today's ruling, Obamacare has now been approved by all three branches of our government, having garnered majorities in the House of Representatives and Senate, been signed into law by the President, and found to be constitutional by the Supreme Court," Cook said. "It is now time for Republicans and Democrats to stop the partisan gamesmanship and work together to fix the parts of the law that are broken while improving upon those that provide real benefits to the American people. While I believe Obamacare has real flaws, I do not support repealing the law in its entirety and replacing it with nothing, as proposed by many of the law's opponents. To do so would strip coverage from countless young men and women who are now able to stay on their parents' insurance until the age of 26, increase prescription drug prices for seniors, and provide no solutions for those uninsured Americans with pre-existing medical conditions. Instead, if elected I would seek to be part of a constructive, bi-partisan effort to improve the law as necessary and successfully reform our health care system."

***

U.S. Sen. Mark Warner said he is ready to move "forward in a bipartisan way on how we can further bring down the costs of health care."

"I am pleased the Supreme Court has upheld the constitutionality of health reform," Warner said. "I have always felt the Affordable Care Act was weighted more toward the issue of coverage and not enough toward cost containment.

"I look forward to now moving forward in a bipartisan way on how we can further bring down the costs of health care. We must focus the health care system more on outcomes than simply on the volume of services provided."

"Like the underlying legislation that it addresses, today's 5-4 ruling by the Supreme Court on the constitutionality of the Patient Protection and Affordable Care Act (PPACA) is lengthy and complex," Rigell said. "I will be reviewing the decision thoroughly so I can fully understand the practical implications of the ruling.

"A cursory review, however, makes it clear that much of the PPACA has been ruled constitutional. This is deeply disappointing because it sets a legal precedent that greatly expands government's ability to "mandate" other aspects of American life. For the first time in our history, Americans will be taxed not for what they purchase, but for what they have not purchased. That is wrong, and in my view, unconstitutional."

***

The National Patient Advocate Foundation (NPAF) today applauded the U.S. Supreme Court decision to uphold the Patient Protection and Affordable Care Act (PPACA) and its important insurance coverage protections for patients, including the elimination of pre-existing conditions as a barrier to coverage, the elimination of annual and lifetime caps on insurance coverage and the capping of out-of-pocket health care expenditures.

"The protections under the PPACA are especially important to the patients served by the Patient Advocate Foundation, because each of them determines, first, whether a patient will have access to important health services, and second, whether a patient can afford the health care they require," said Nancy Davenport-Ennis, founder and CEO of NPAF, and CEO of the Patient Advocate Foundation in Hampton. "We are pleased that the Supreme Court has opted to maintain these key provisions by upholding the PPACA, and we look forward to working with policymakers and the broader health care community in making certain that these patient protections continue to assist the millions of Americans that they were intended to help."

***

Lt. Gov. Bill Bolling said the "court's decision does not change the fact that Obamacare is bad policy."

"I am very disappointed by the Supreme Court's decision to uphold the constitutionality of Obamacare," Bolling said. "It was my belief that the President and Congress overstepped their constitutional authority in requiring American citizens to purchase a product like health insurance, and I am disappointed that the Supreme Court reached a different conclusion. However, the court's decision does not change the fact that Obamacare is bad policy. Obamacare is too costly and we cannot afford it. In addition, Obamacare increases the cost of doing business and makes it harder for American businesses to hire workers. Finally, Obamacare limits American's health care choices and intrudes on the doctor-patient relationship."

***

Earlier in the day when issuing his intial response to the decision Attorney General Ken Cuccinelli called it a "dark day for Liberty." Since then after more fully reviewing the decision Cuccinelli said at a press conference that it is now victory for Liberty because of the ruling on the Commerce Clause of the Constitution.

"On the liberty side we won," Cuccinelli said. "There were five votes today and it was a holding that the Commerce Clause does not allow the federal government to compel American's to buy a product. That was a holding of the case. That was a necessary holding before they got to the up holding of the penalty for the failure to buy the government approved health insurance."

***

Dean Longo, the Republican candidate challenging U.S. Rep. Robert C. "Bobby" Scott in the 3rd Congressional District, said "It's a political issue now."

"There's no question we need to facilitate good health care, not force a broken health care system on people," Longo said. "There's no question there are people out there that need health care through no fault of their own. This doesn't actually fix anything. Whether you want to call it an unconstitutional mandate or you want to call it a tax, in the end it's not going to fix very much what so ever."

***

Paul Hirschbiel, the Democratic candidate challenging U.S. Rep. Scott Rigell in the 2nd Congressional District, said it is time to work in a bipartisan way to build on reforms that have been made."

"Now that the court has ruled, it's time that we turn our focus to the future," Hirschbiel said. "Too many Virginia families are still struggling to get affordable quality health care and too many American small businesses are being held back by the high cost. We deserve leaders who will work across the aisle to build on reforms that have been made and improve them to ensure health care is more affordable for the middle class and small businesses."

***

Congressman J. Randy Forbes, R-Chesapeake, said the decision was a "misguided judgement."

"The Court today shattered the myth that it would stand between the overreaching decision of government and the individual liberty of citizens," Forbes said. "Chief Justice Roberts emphasized that the Court would not protect the American people from the bad political decisions of their elected officials. The Supreme Court decision today is disappointing, but underscores the importance of electing officials who support individual freedoms and a more limited vision of government. The President's health care law increases costs for employers, leaving some businessmen with the choice between laying off employees or paying the penalty associated with failure to purchase health insurance. This misguided judgment signals that there are no longer any real limitations on what the government can mandate on the citizens of this nation."

***

Congressman Robert C. "Bobby" Scott, D-Newport News, called the decision a "win for Americans."

"I am pleased that today's U.S. Supreme Court decision leaves intact nearly all of the provisions of the Affordable Care Act, most importantly the 'individual mandate,' Scott said. "This law is a milestone towards expanding affordable health coverage to all Americans, regardless of age, income, or preexisting condition. Young Americans can continue to stay on their parent's polices until they are twenty-six, seniors will not be pushed back into the 'donut-hole', and health insurance companies will not be able to put a lifetime limit on your health coverage."

***

Tom Inman, who owns Virginia Home Medical, a Newport News medical supply company with 20 employees, said the decision would only drive up the cost of health care premiums for small businesses.

Inman pays so his 20 employees are covered, but he said that won't necessarily remain the case if buying coverage becomes unaffordable. Businesses with fewer than 50 full-time equivalent employees aren't required to provide coverage under the law.

"I've provided health insurance for 30 years, but I'm now having to look at it, and this is not going to help the decision," Inman said.

* * *

Troy Smith Jr., a who owns Smith Brothers Hardwood & Flooring in Newport News, said he's encouraged by the decision and is hopeful it will reverse what seems like a steady rising of health insurance costs.

Smith said he recently learned last week the premium are rising by 8 percent this year, which constrains what he can do as a business owner.

"Frankly speaking, our employees haven't had raises in several years, and that's a direct hit," Smith said.

* * *

Anthem Blue Cross Blue Shield spokesman Scott Golden, said "the road to implementing health care reform will be a challenge."

"However, we look forward to working constructively with policymakers and other key stakeholders to build a health care delivery system that provides security and affordability to all Americans."

* * *

Peter Glagola, spokesman for Riverside Health System, said the nonprofit is still studying the decision: "There's a lot we still don't know. We have a 190-page document that we're reading now."

* * *

The majority leader of Virginia's Senate -- Thomas K. "Tommy" Norment, R-James City County -- said the decision highlights the "importance" of Virginia in the upcoming federal elections.

"The decision of the Supreme Court to uphold the Patient Protection and Affordable Care Act is a painful setback for individual liberty and federalism," Norment said. "Today's decision serves as a reminder that essential change must ultimately be achieved through the ballot box.

"The decision increases the importance of Virginia in this year's elections. If Virginia votes for Mitt Romney for president and sends George Allen to the United States Senate, the chances of repealing this onerous overreach by the federal government increase exponentially."

* * *

Maria Kokolis, psychologist and director of Tidewater Physicians Multispecialty Group's STRIVE in Newport News and Williamsburg, which has an outpatient obesity treatment program, says, "To get insurance coverage is everything we want for our patients."

* * *

Virginia Attorney General Ken Cuccinelli, who challenged the Affordable Care Act in the courts, offered an initial response to the decision that will be followed by a press conference later today.

"This is a dark day for the American people, the Constitution, and the rule of law," Cuccinelli said. "This is a dark day for American liberty."

"This decision goes against the very principle that America has a federal government of limited powers; a principle that the Founding Fathers clearly wrote into the Constitution, the supreme law of the land. The Constitution was meant to restrict the power of government precisely for the purpose of protecting your liberty and mine from the overreaching hand of the federal government."

* * *

Gov. Bob McDonnell called the decision "dissapointing."

"Today's Supreme Court ruling is extremely disappointing for Virginia and for America," McDonnell said. "The PPACA will create a costly and cumbersome system that will impair our country's ability to recover from these challenging economic times, infringes on our citizens' liberties, will harm small businesses, and will impose dramatic unfunded mandates on Virginia and all states. Simply put, this is a blow to freedom. America needs market-based solutions that give patients more choice, not less."

* * *

U.S. Senate candidate and former Gov. Tim Kaine said there is still "more work" to do.

"While there is more work to do, it is worth noting what has already been accomplished under the Affordable Care Act. Nearly 63,000 more young people in Virginia have health coverage, more than 800,000 Virginia seniors have received free preventive care, millions of small businesses are now eligible for tax credits, and 20 million American women have access to cancer screenings and contraception without co-pays," Kaine said. " And we've put an end to the egregious abuses by insurance companies that denied coverage to children with preexisting conditions, charged women higher premiums for the same coverage, and dropped folks when they got sick."

* * *

U.S. Senate candidate and former Gov. George Allen said he wants to be the deciding vote in the Senate to repeal the Affordable Care Act next year.

"While disappointed in the Supreme Court's decision on President Obama's health care law, I believe it reinforces what is truly at stake during this pivotal election," Allen said. "This November, the American people have an opportunity to choose new leadership in Washington who will listen to their voices and repeal this costly, harmful government health-care law."